Related Experiment Video

Updated: Feb 6, 2026

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

Published on: October 25, 2024

Microvascular Outcomes in Patients With Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study

Rebecca O'Brien¹, Eric Johnson², Sebastien Haneuse³

¹The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California (R.O., D.P.F., S.S.).

Annals of Internal Medicine

|August 8, 2018

Abstract

Background:

Bariatric surgery improves glycemic control in patients with type 2 diabetes mellitus (T2DM), but less is known about microvascular outcomes.

Objective:

To investigate the relationship between bariatric surgery and incident microvascular complications of T2DM.

Design:

Retrospective matched cohort study from 2005 to 2011 with follow-up through September 2015.

Setting:

4 integrated health systems in the United States.

Participants:

Patients aged 19 to 79 years with T2DM who had bariatric surgery (n = 4024) were matched on age, sex, body mass index, hemoglobin A1c level, insulin use, diabetes duration, and intensity of health care use up to 3 nonsurgical participants (n = 11 059).

Intervention:

Bariatric procedures (76% gastric bypass, 17% sleeve gastrectomy, and 7% adjustable gastric banding) compared with usual care.

Measurements:

Adjusted Cox regression analysis investigated time to incident microvascular disease, defined as first occurrence of diabetic retinopathy, neuropathy, or nephropathy.

Results:

Median follow-up was 4.3 years for both surgical and nonsurgical patients. Bariatric surgery was associated with significantly lower risk for incident microvascular disease at 5 years (16.9% for surgical vs. 34.7% for nonsurgical patients; adjusted hazard ratio [HR], 0.41 [95% CI, 0.34 to 0.48]). Bariatric surgery was associated with lower cumulative incidence at 5 years of diabetic neuropathy (7.2% for surgical vs. 21.4% for nonsurgical patients; HR, 0.37 [CI, 0.30 to 0.47]), nephropathy (4.9% for surgical vs. 10.0% for nonsurgical patients; HR, 0.41 [CI, 0.29 to 0.58]), and retinopathy (7.2% for surgical vs. 11.2% for nonsurgical patients; HR, 0.55 [CI, 0.42 to 0.73]).

Limitation:

Electronic health record databases could misclassify microvascular disease status for some patients.

Conclusion:

In this large, multicenter study of adults with T2DM, bariatric surgery was associated with lower overall incidence of microvascular disease (including lower risk for neuropathy, nephropathy, and retinopathy) than usual care.

Primary Funding Source:

National Institute of Diabetes and Digestive and Kidney Diseases.

More Related Videos

Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

Published on: March 23, 2019

Duodenal-Jejunal Bypass Surgery in Diet-Induced Obese Diabetic Mice

Duodenal-Jejunal Bypass Surgery in Diet-Induced Obese Diabetic Mice

Published on: October 18, 2024

Related Concept Videos

Patient-centered Care

Patient-centered Care

Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...

Sign Test for Matched Pairs

Sign Test for Matched Pairs

The sign test for matched pairs offers a robust method for comparing two paired samples, often for the effects of an intervention in one of them. This method is very useful in situations where the underlying distribution of the data is unknown. The test compares two related samples—often pre- and post-treatment measurements on the same subjects—to determine if there are significant differences in their median values.
To conduct the sign test, we first calculate the differences in...

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...

Predicting Reaction Outcomes

Predicting Reaction Outcomes

Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...

Outcomes of Glycolysis

Outcomes of Glycolysis

Nearly all the energy used by cells comes from the bonds that make up complex organic compounds. These organic compounds are broken down into simpler molecules, such as glucose. As a result, cells extract energy from glucose over many chemical reactions—a process called cellular respiration.
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...

Articles linked to this work by shared authors, journal, and citation graph.

Desmoglein-2 F833C Is Predicted to Disrupt Hydrophobic Interactions With the Armadillo Repeat Region 1 of Plakoglobin.

Cureus·2026

Changes in Quality of Life and the Impact of Frailty After Fenestrated-Branched Endovascular Repair of Pararenal and Thoracoabdominal Aortic Aneurysms.

Journal of vascular surgery·2026

BroadSCOPE: An Optical Broadband Seismic Sensor for Planetary Exploration.

Space science reviews·2026

Trends in utilization of glucagon-like peptide‑1 receptor agonists, sodium-glucose cotransporter‑2 inhibitors, and metabolic bariatric surgery in U.S. adults with diabetes and obesity.

Diabetes research and clinical practice·2026

The atypical IκB factor IκBδ enhances CD8 T cell accumulation and effector functions in solid tumors.

bioRxiv : the preprint server for biology·2026

Methodological Approaches to Real-World Evidence Generation for Glucagon-like Peptide-1-Based Therapies: Synopsis of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop.

Annals of internal medicine·2026

See all related articles